Low Income Subsidy

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Low Income Subsidy

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Extra Help with Prescription Drug Cost

Anyone who has Medicare can get Medicare prescription drug coverage. Some people with limited resources and income may also be able to get Extra Help to pay for the costs related to a Medicare prescription drug plan, such as; monthly premiums, annual deductibles, and prescription co-payments. The Extra Help is estimated to be worth about $4,900 per year. This Extra Help would apply to the prescription drug portion of a Medicare Advantage Plan, thereby lowering your premium for that plan if you have a premium, or a stand-alone Prescription Drug Plan. Many people qualify for these important savings and don’t even know it. Also see Medicare Savings Programs below.

To qualify for Extra Help:

• Your resources (assets) must be limited to $9,900 for an individual or $15,600 for a married couple living together (These numbers take into account the permitted $1,500 burial exclusion from your resources) . Resources include such things as bank accounts, stocks, and bonds. They do not count your home, car, or any life insurance policy as resources; and

• Your monthly income must be limited to $1,549 for an individual or $2,080 for a married couple living together. Even if your annual income is higher, you still may be able to get some help.

EXCEPTION: Even if you meet these conditions, DO NOT complete this application if you have Medicare and Supplemental Security Income (SSI) or Medicare and Medicaid because you automatically will get the extra help.

How do I Apply?

Applying for Extra Help is easy. Just complete Social Security’s Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020). Here’s how:

  • Call me, Richard Sanchez, to assist you in applying for Extra Help, or
  • Apply online at www.socialsecurity.gov/extrahelp;
  • Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone or to request an application; or
  • Apply at your local Social Security office.

After you apply, Social Security will review your application and send a letter to you to let you know if you qualify for Extra Help. Once you qualify, you can choose a Medicare prescription drug plan. If you don’t select a plan, the Centers for Medicare & Medicaid Services will do it for you. The sooner you join a plan, the sooner you begin receiving benefits. If you aren’t eligible for Extra Help, you still may be able to enroll in a Medicare prescription drug plan.

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Medicare Savings Programs

Can state agencies help with my Medicare costs? When you file your application for Extra Help, you also can start your application process for the Medicare Savings Programs. These state programs provide help with other Medicare costs. Social Security will send information to your state unless you tell them not to on the Extra Help application. Your state will contact you to help you apply for a Medicare Savings Program. These Medicare Savings Programs help people with limited resources and income pay for their Medicare expenses. The Medicare Savings Programs help pay for your Medicare Part B (outpatient services) premiums. For some people, the Medicare Savings Programs may also pay for Medicare Part A (inpatient hospital services) premiums, if any, and Part A and B deductibles and co-payments. Medicaid or medical assistance is a joint Federal and state program that helps pay medical costs for some people who have limited resources and income. Each state has different rules about eligibility and applying for Medicaid. Contact your state Medicaid office for more information.

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